增强CT在急性阑尾炎诊断中评估疾病严重程度：CT表现与组织学诊断的比较

Enhanced CT in the diagnosis of acute appendicitis to evaluate the severity of disease: comparison of CT findings and histological diagnosis.

作者信息

Mori Y, Yamasaki M, Furukawa A, Takahashi M, Murata K

机构信息

Department of Radiology, Shiga University of Medical Science, Otsu, Japan.

出版信息

Radiat Med. 2001 Jul-Aug;19(4):197-202.

PMID:11550720

Abstract

PURPOSE

To assess the potential of CT in evaluating the histological severity of acute appendicitis in comparison with surgical and pathological findings.

METHOD

The CT images of 75 patients with surgically proven appendicitis, including 10 cases of catarrhal, 34 of phlegmonous, and 31 of gangrenous appendicitis, were retrospectively analyzed for the following five CT findings: (1) hazy periappendiceal densities, (2) enlarged appendix, (3) increased enhancement of the appendiceal wall, (4) increased enhancement of the periappendiceal intestinal wall, and (5) deficiency of the appendiceal wall. By comparing all the CT findings and the pathological severity of appendicitis (catarrhal, phlegmonous, and gangrenous), the prevalence of the five CT findings was calculated for each pathological category.

RESULTS

Abnormal CT findings were noted in only one case of catarrhal appendicitis. Increased enhancement of the appendiceal wall was observed in all 29 cases of phlegmonous appendicitis (100%), but in only 66.7% (18 cases) of gangrenous appendicitis. Deficiency of the appendiceal wall was more frequently observed in gangrenous (19/27, 70.4%) than phlegmonous appendicitis (4/29, 13.8%).

CONCLUSION

Findings of enhanced CT provide useful information in evaluating the pathological severity of acute appendicitis.

摘要

目的

与手术及病理结果相比，评估CT在评价急性阑尾炎组织学严重程度方面的潜力。

方法

回顾性分析75例经手术证实为阑尾炎患者的CT图像，其中包括10例卡他性阑尾炎、34例蜂窝织炎性阑尾炎和31例坏疽性阑尾炎，分析以下五项CT表现：（1）阑尾周围模糊密度影；（2）阑尾增粗；（3）阑尾壁强化增加；（4）阑尾周围肠壁强化增加；（5）阑尾壁缺损。通过比较所有CT表现与阑尾炎的病理严重程度（卡他性、蜂窝织炎性和坏疽性），计算每个病理类型中五项CT表现的发生率。